Kashmir's new battle with drugs

KASHMIR -- Two decades of conflict has led to a drastic rise in the use of medical opiates in the Kashmir Valley. Doctors warn of a brewing health crisis but the government doesn't have a plan to deal with drug abuse.

(Srinagar, Kashmir) -- Ali shuffles across the quiet yard of a drug de-addiction centre in Srinagar, the capital of India-administered Kashmir. The 26-year-old sought help after a decade of using drugs ranging from brown sugar to codeine. Ali recalled being high when he was training with militants for jihad. “It used to make me feel strong and motivated,” he said. “I felt I could do anything.”

For two decades, the people of Kashmir have endured the fighting between the Indian army and the militants. The impact of the long-drawn conflict is now surfacing in the form of deteriorating mental health in the Valley along with a drastic rise in drug abuse. The state government of Jammu and Kashmir, however, is ill-equipped to arrest the problem.

Traditional drugs like opium and cannabis have always been part of the landscape. Now, people have turned increasingly to medical opiates that are being sold illegally by chemists. “This was not a problem a decade or so ago,” said Abdul Gani Mir, Deputy Inspector General of Police in Kashmir. “It is emerging as a real threat to society.”

Failed relationships, failed exams and unemployment are the most common reasons for drug abuse. Ahmed, 25, became addicted to drugs after his parents did not allow him to marry the girl he loved. “I was missing her a lot,” he said. “After I took the pills, I felt numb and didn’t pick up her calls.”

Mohammed, a middle school teacher, used to teach students when he was under the influence of the codeine drug. “I can’t explain…it was boredom,” he said. Doctors say that these seemingly mundane problems are severely aggravated due to the impact of the conflict on the society’s psyche.

The government mental hospital, which in 1989 received not more than 2000 patients a year, is now being visited by close to 100,000 patients in the year. The number of suicides is also rising rapidly, according to the local police.

Tens of thousands of men and boys have been killed or “disappeared” in Kashmir--one of the most heavily militarized places in the world. Pakistan, which wants Kashmir out of India’s hands, has deployed militants to fight here. Last year, however, has been peaceful. The calm has also lured in a record number of tourists who come to experience the natural beauty of the embattled region. While people are able to walk on safer streets, they say that the outward peace cannot mask their inner turmoil.
Inadequate government response

It is estimated that there are more than 200,000 drug addicts in the Valley. But, there are only two de-addiction centers with ten beds each. “We are denying it, we are delaying it and we are pushing them into more drugs,” said Muzaffar Khan, the psychiatrist who runs the first government de-addiction centre. “Even this center…today this is a priority for the police, tomorrow it could change.”

The center, which was started in 2008 by the local police, continues to be located inside the police headquarters in Srinagar. It has, so far, treated 271 people—the majority on an out- patient basis. There is a waiting list of 326.

The government departments responsible for health and drug control have been faulted for failing to arrest the problem. Sheikh Mehmood, the Senior Superintendent of Police, pointed out that it isn’t the regular work of the police to be running a de-addiction centre. “We did it before the health department because we felt the need,” he said.

Mehmood noted that some militants behind the previous “fidayeen attacks” (suicide attacks) were under the influence of drugs. More recently, drugs had led to an increase in crime, accidents and school dropouts. Children, as young as 12, are getting hold of drugs. This led to several awareness workshops being organized in schools and college campuses. The number of drug peddlers arrested increased from 65 in 2008 to 189 in 2011.

Chemists, however, are easily able to sell prescription drugs over the counter for higher prices. One chemist, speaking on condition of anonymity, admitted that he was selling more drugs. “What do you think years of violence does to people,” he asked. “If someone takes a medicine and is able to forget his troubles and sleep for a while then is something wrong with that?”

Nazir Ahmed Wani, deputy drug controller for Kashmir, insisted that the local Drug Controlling Agency was clamping down on the illegal sale of prescription drugs. “Whenever we hear of a problem, we are acting on it right away,” he said. But in Srinagar, only six licenses have been suspended and two establishments sealed.

Activists and doctors, disappointed by the state response, are calling for a new drug policy for the state of Jammu and Kashmir to regulate the distribution of medical opiates and crackdown on illegal suppliers.

Another problem is that the two rehabs, located in the capital, are not accessible to people in the countryside where medical opiates is also on the rise, and law-enforcement is a challenge. Abdul Gani Raina, a doctor in the neighboring Budgam district, described two drug-related deaths in nearby villages. One victim fell into a lake after an overdose and another fell out of a train. “The problem is increasing day by day,” he said.

Drug addiction is compounded by a lack of awareness about the nature of the problem. Ailments such as anxiety, sleeplessness and depression are not seen as medical disorders. Resulting addiction is a stigma and psychiatrists are viewed with suspicion. “They demonize the doctor and the patient,” said Akash Yusuf Khan, a government psychiatrist.

Khan is one of the three psychiatrists ever to be appointed by the state government—for the first time this year. According to him, rehab centers are useful in the United States where there is a history of treating addiction. He said, “Psychiatry is culture bound,” and suggested that the problem in Kashmir could be tackled by de-stigmatizing patients and then involving the family to help in their recovery.

Addiction among girls

Increasing drug use among women and girls in the Kashmir Valley is one of the more troubling aspects due to a reticence to come forward for seeking help. Women who have lost husbands and sons in the conflict are dealing with grief, apart from struggling to keep their children out of poverty. Drug use has in recent years spiked among school and college girls who resort to solvents, petrol, glue and boot polish.

According to an estimate, there are 4000 female drug addicts in the Valley where women taking drugs was previously unheard of. But doctors double that figure. So far, only 11 females have called the police de-addiction centre hotline, constrained by fear of parental wrath and disgrace in the community.

The second de-addiction center, which opened four months ago, has not received any women. “We simply don’t have the resources to help them,” said Yasir Rather, the psychiatrist who oversees this rehab. There is no female psychiatrist in the Valley. In the absence of a specialist, the general practitioners and activists are taking upon themselves the task of counseling young people.